The study examined prevalence, awareness, treatment and control of hypertension (HTN), and associated factors and to evaluate the trend in hypertension between 2009 (period 2) and 1994-1998 (period 1). A national sample of 4117 adults aged 25 years and older was selected. Prevalence rate of HTN (SBP ≥ 140 or DBP ≥ 90 or on antihypertensive therapy) was 32.3% and was higher than the 29.4% prevalence rate reported in period 1. Prevalence rate was significantly higher among males, older age groups, least educated, obese, and diabetics than their counterparts. The rate of awareness among hypertensives was 56.1% and was higher than the 38.8% rate reported form period 1 data. Awareness was positively associated with age, smoking, and diabetes for both men and women, and with level of education and body mass index for men. Rate of treatment for HTN among aware patients was 63.3% and was significantly higher than the 52.8% rate reported in period1. Control rate of HTN among treated hypertensives was 39.6%; significantly higher than the 27.9% control rate in period 1. Control of HTN was positively associated with age but only for women. In conclusion, HTN is still on the rise in Jordan, and levels of awareness and control are below the optimal levels.

Although low serum 25-hydroxyvitamin D (25(OH)D) and elevated serum parathyroid hormone (PTH) have been associated with depression in clinical settings, this link in community-dwelling individuals is inconclusive. The present study aimed at examining the association between serum 25(OH)D and PTH levels and the presence of depression in a national population-based household sample of 4,002 Jordanian participants aged ≥25 years. The DASS21 depression scale was used to screen for depression, and serum concentrations of 25(OH)D and PTH were measured by radioimmunoassay. Multiple logistic regression models were used to explore the association between serum 25(OH)D and PTH levels and depression. The unadjusted odds ratio (OR) decreased linearly with increasing quartiles of serum 25(OH)D (P (trend) = 0.00). The OR for having depression was significantly higher among individuals in the first and second quartiles (OR = 1.4, 1.23, respectively) than among those in the fourth quartile (P values = 0.00 and 0.03, respectively). This relationship remained significant after adjusting for age, sex, marital status, education, BMI, serum creatinine, number of chronic diseases (OR = 1.39 and 1.21 and P values = 0.00 and 0.05, respectively) and after further adjustment for exercise, altitude, and smoking (OR = 1.48 and 1.24, respectively, and P values = 0.00 and 0.03, respectively). No significant association was found between serum PTH levels and depression. The decrease in risk of depression among participants started to be significant with serum 25(OH) D levels higher than 42.3 ng/ml (lower limit of the range of the third quartile). This value may help pinpoint the desirable level of serum 25(OH)D to be attained to help aid the prevention and treatment of depression.

Abstract Objective. To estimate the prevalence of overweight and obesity among Jordanian children and adolescents and to determine their association with metabolic abnormalities. Methods. In a national population-based household survey, a systematic sample of households was selected. All members aged ?7 years in the selected households were invited to participate in the study. Of the respondents, 1,034 subjects were 18 years old or younger. Anthropometric and biochemical measurements were obtained. Overweight and obesity were defined according to age and sex specific cut-off points of BMI defined by the International Obesity Task Force criteria proposed by Cole et al. The metabolic abnormalities were defined for subjects, based on their age, according to the definition of Cook et al. and International Diabetes Federation (IDF) criteria. Results. The overall prevalence of overweight and obesity among children were 6.0% and 5.5%, respectively. Among adolescents, the overall prevalence rates of overweight and obesity were 13.7% and 10.0%, respectively. After adjusting for gender and age, overweight was significantly associated with increased odds of having high triglycerides (Odds ratio [OR]= 1.7), low HDL-cholesterol (OR = 1.9), and at least one metabolic abnormality (OR = 2.2). Obesity was significantly associated with increased odds of individual metabolic abnormalities and their clustering. Conclusions. A relatively high proportion of Jordanian children and adolescents had overweight or obesity. Overweight and obesity in children and adolescents were associated with increased odds of metabolic abnormalities and their clustering. Programs addressing eating behavior and physical activity of children and adolescents to maintain a healthy weight are needed in Jordan.

Evidence of the association between 25-hydroxyvitamin D (25(OH)D) and metabolic syndrome (MeS) remains uncertain and incongruent. This study aimed to determine the association between 25(OH)D and MeS among Jordanian adults. A complex multistage sampling technique was used to select a national population-based household sample. The present report deals exclusively with adults aged > 18 years who had complete information on all components of MeS (n = 3,234). A structured questionnaire was used to collect all relevant information. Anthropometric, clinical, and laboratory measurements were obtained. MeS was defined according to the International Diabetes Federation (IDF) definition. Of the total, 42.0% had MeS and 31.7% had 25(OH)D < 30 ng/ml. In a stratified analysis, the prevalence of MeS did not differ significantly between subjects with low and normal 25(OH)D levels for men and women in all age groups. In the multivariate analysis, the odds of MeS were not significantly different between subjects with low and normal 25(OH)D levels (OR = 0.85, 95% CI: 0.70, 1.05, P-value = 0.133). The association between 25(OH)D and MeS remained non-significant when 25(OH)D was analyzed as a continuous variable (OR = 1.004, 95% CI; 1.000, 1.008, P = 0.057) and when analyzed based on quartiles. None of the individual components of MeS were significantly associated with 25(OH)D level. This study does not provide evidence to support the association between 25(OH)D level and MeS or its individual components. Prospective studies are necessary to better determine the roles of 25(OH)D levels in the etiology of MeS.

PURPOSE This study explores the prevalence, type, frequency, purpose and pattern of herbal preparation use as complementary and alternative medicine (CAM) in a cohort of patients with diabetes in Jordan. METHOD The study took the form of a cross-sectional survey of patients attending the outpatient departments at The National Centre for Diabetes, Endocrine and Genetics (NCDEG), in Amman. The method was based on semi-structured questionnaire. RESULTS A total of 1000 diabetes patients were interviewed. Of the participants, 16.6%(n=166) reported using herbs. Most of CAM users were in the age group 51-60 years (n=73, 44.0%) and predominantly female (59.6%). 139 of the CAM users (83.7%) had at least obtained a high school degree. The most common herbal product to be used was green tea (20.5%). CONCLUSION This study confirmed that there is an appreciable prevalence of herbal use among patients with diabetes in Jordan.

Background and Objectives : Since the extent of elevation of liver transaminases in type 2 diabetics in Jordan and most of the Middle East is unknown, we estimated the prevalence of elevated liver transaminase levels among patients with type 2 diabetes and determined associated risk factors. Methods : This study was performed on 1014 consecutive type 2 diabetic outpatients who attended the National Center for Diabetes, Endocrinology and Genetics in Amman, Jordan. The patients' age ranged between 26-85 years with a mean age of 56.8 (+9.8). Three- hundred and fifty three (54.5%) were males with a median age of 58 years (ranging between 26-82 years), and four hundred and sixty one (45.5%) were females with a median age of 57 years (ranging between 28-85 years). Body mass index, waist circumference, lipid profile, and hepatic transaminase levels were recorded. Ultraonography was performed in those with elevated alanine transaminase levels. Results : Overall, the prevalence of elevated alanine transaminase (ALT) level was 10.4%(n=105) with the gender-wise prevalence being 12.8%(n=71) in men and 7.4%(n=34) in women. The prevalence of elevated aspartate transaminase (AST) levels was 5.4%(n=56) with the gender-wise prevalence being 5.6%(n=31) in men and 5.4%(n=25) in women.. Only 4.5%(n=44) showed elevated levels of both ALT and AST. Male gender (OR=2.35, CI:1.5-3.8) and high waist circumference (OR=1.9, CI:1.2-3.2) were associated with increased risk of elevated ALT levels. Younger patients had a higher tendency to have elevated ALT compared to those over 65 years (OR=12.4 for patients aged 25-45years, and OR=5.8 for those who were 45-65 years old). Non-insulin use was associated with a high odds ratio for elevated ALT levels (OR=1.7, CI: 1.1-2.9). Conclusions : Elevated ALT and AST levels are found in 10.4% and 5.4% of our type 2 diabetic patients respectively. Male gender, younger age, higher waist circumference; as an indicator of central obesity, as well as non insulin use are independent predictors of elevated liver transaminase levels.

Background: Female sexual dysfunction (FSD) is defined as disorders of libido, arousal, and orgasm, as well as sexual pain, that leads to personal distress or interpersonal difficulties. Social aspects of FSD have been understudied. The aim of this study was to explore the social aspects of FSD and sexual attitudes of Jordanian women. Subjects and Methods: Six hundred thirteen married females were studied between October 2006 and August 2007 at the National Center for Diabetes, Endocrinology and Genetics (NCDEG), Amman, Jordan. Females were interviewed using a special questionnaire that was suitable to our culture and added to the Arabic translation of the Female Sexual Function Index (FSFI) Questionnaire. Results: Older age was associated with a decreased total FSD index and its domain scores. Women with obesity were more likely to have impaired arousability and impaired capability of reaching orgasm. About 58.5% of women reported that they prepared themselves if they had sexual desire and 68.2% reported wearing special attire for this purpose. Only 37.2% of women could ask their husband for a special excitement. Conclusions: FSD is prevalent in Jordan. Its social aspects are understudied and need more research in the future.

OBJECTIVES: Determine factors associated with poor glycemic control among Jordanian patients with Type 2 diabetes. METHODS: A systematic random sample of 917 patients was selected from all patients with Type 2 diabetes over a period of 6 months in 2008. A prestructured questionnaire sought information about sociodemographic, clinical characteristics, self-care management behaviours, medication adherence, barriers to adherence, and attitude towards diabetes. Weight, height, and waist circumferences were measured. All available last readings of hemoglobin A1c (HbA1c), fasting blood sugar measurements and lipid were abstracted from patients' records. Poor glycemic control was defined as HbA1c >/=7%. RESULTS: Of the total 917 patients, 65.1% had HbA1c >/=7%. In the multivariate analysis, increased duration of diabetes (>7 years vs.</=7years)(OR=1.99, P</=.0005), not following eating plan as recommended by dietitians (OR=2.98, P</=.0005), negative attitude towards diabetes, and increased barriers to adherence scale scores were significantly associated with increased odds of poor glycemic control. CONCLUSION: The proportion of patients with poor glycemic control was high, which was nearly comparable to that reported from many countries. Longer duration of diabetes and not adherent to diabetes self-care management behaviors were associated with poor glycemic control. An educational program that emphasizes lifestyle modification with importance of adherence to treatment regimen would be of great benefit in glycemic control.

OBJECTIVE: To determine the frequency and patterns of dyslipidemia in patients with type 2 diabetes mellitus (DM) and to estimate the effects of sociodemographic and clinical variables on dyslipidemia. METHODS: The setting took place in The National Center for Diabetes, Endocrinology and Genetics (NCDEG) at the University of Jordan, Amman, Jordan. The NCDEG is the only referral center in the country; therefore, the patients represent the population in different parts of the country. A cross-sectional design was used. A total of 702 patients with DM from the NCDEG aged >/=20 years were consecutively enrolled between June 2005 and July 2006. Medical record abstraction of sociodemographic, clinical, and laboratory data was performed. RESULTS: The frequency of hypercholesterolemia was 77.2%, low high-density lipoprotein (HDL) was 83.9%, high low-density lipoprotein (LDL) was 91.5%, and hypertriglyceridemia was 83.1%. Females had greater abnormalities in lipid profiles. High LDL-cholesterol was the most common dyslipidemia in combination (91.5%) and in isolation (12.8%). Gender and hemoglobin A1C (HbA1c) predicted high total cholesterol; age and hypothyroidism predicted low HDL-cholesterol, gender predicted high LDL-cholesterol; and use of beta-blockers predicted high triglycerides. CONCLUSION: Over 90% of patients with type 2 DM had one or more types of dyslipidemia. The most common dyslipidemia in our study was high LDL-cholesterol and high triglycerides as reported in the literature. We recommend aggressive drug management, education, counseling, and behavioral interventions.